Jose Alberto Nino outlines the plan at The Unz Review:
On a December evening in 2020, [President Donald] Trump granted clemency to Philip Esformes, a South Florida nursing home operator serving a 20-year sentence for orchestrating what federal prosecutors called the largest individual healthcare fraud scheme ever prosecuted in American history. The commutation freed Esformes from prison after he had served just over four years, though it left his conviction and roughly $44 million in financial penalties intact.
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The first warning signs emerged in 2006 when Esformes and associates connected to Larkin Community Hospital reached a civil settlement with federal and Florida authorities. The $15.4 million agreement resolved allegations involving kickbacks and admitting patients for medically unnecessary treatment. Though the settlement required no admission of wrongdoing, prosecutors later pointed to this episode as evidence that suspicious conduct continued unchecked.
A decade later, federal authorities brought criminal charges that painted a portrait of systematic fraud on an unprecedented scale. In July 2016, prosecutors indicted Esformes on multiple counts related to what they described as a roughly $1.3 billion scheme to defraud Medicare and Medicaid. The government’s case detailed an intricate operation designed to maximize profits by manipulating patient care and gaming federal reimbursement rules.
According to court filings, Esformes orchestrated a system that moved beneficiaries among hospitals, skilled nursing facilities, and assisted living centers in carefully timed patterns. These transfers satisfied Medicare eligibility requirements such as mandatory three-day hospital stays and 100-day skilled nursing limits, allowing facilities to restart billing cycles regardless of whether patients actually needed the care. Prosecutors alleged that medical decisions took a back seat to financial calculations.
The scheme allegedly extended beyond unnecessary services. Federal authorities claimed Esformes paid kickbacks and bribes to physicians and physician assistants who referred patients to his network. These illegal payments flowed through intermediaries and were disguised as legitimate business expenses. Some payments were allegedly hidden as charitable donations, prosecutors said, while others appeared in fake contracts and invoices designed to conceal their true purpose.
Parker here. That’s just one way to get filthy rich in the healthcare industry. I wonder how much money Esformes got to keep in exchange for his four years in prison. I wonder if Esformes paid a substantial “donation”in exchange for his clemency.
I quit running my own medical practice in 2001 because I couldn’t make a decent living at it while following the rules.
—–Steve Parker, M.D.
PS: This Unz article illustrates the power we’re up against in trying to reform healthcare.
Paleo Diabetic 